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 During the first 24 hours after chemotherapy, 74 percent of patients
receiving the drug along with their chemotherapy reported no nausea.
That compares to 45 among those getting placebo. The benefits
continued for five days as the drug therapy continued.
"I was overjoyed that the results were statistically significant"
because it was the first study to look at nausea alone, said chief
author Dr. Rudolph Navari of the Indiana University School of
Medicine in South Bend.
Existing drugs are good at preventing vomiting but "we really don't
have any effective anti-nausea treatment," he told Reuters Health.
"That can be a big problem in terms of going to work, taking care of
the kids and quality of life."
"It adds to the number of weapons and options that might be
considered if other strategies are not effective," said Dr. John
Erban, clinical director of the Tufts Medical Center Cancer Center
in Boston, who was not involved in the study.
But a key side effect of olanzapine, extreme fatigue in some
patients, could pose a problem, he said.
The test was done on people who were receiving cisplatin or a
combination of cyclophosphamide and anthracycline for their tumors.
Both regimens are known for producing nausea and vomiting.
Breast cancer was the diagnosis in 64 percent of the patients, lung
cancer in 13 percent and the rest were being treated for other types
of tumors, according to the report published in the New England
Journal of Medicine.
By the end of the five-day treatment period, 37 of those taking
olanzapine had experienced no nausea at all, compared to 22 percent
of placebo recipients.
When the team looked at clinically significant nausea - a score of 3
or more on a 0 to 10 scale – 67 percent of the olanzapine recipients
were free of it during the five-day period versus 49 percent among
those getting standard therapy.
Olanzapine is available in generic form. The five days of treatment
cost about $2.
The patients were only followed for one treatment cycle.
Nonetheless, Navari said, it's likely that the drug's anti-nausea
effect would persist through subsequent cycles.
When used as an antipsychotic, "it’s been given for three, six, nine
months and its effectiveness did not wear off," he said.
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There were no serious side effects, although the drug did produce
severe sedation in 5 percent of recipients around day two. That
subsided over time, the researchers write, "suggesting that the
patients adapted to the sedative effect."
"There's really no drawback to using the drug because it doesn't
cost anything and you only give it a couple of days,” Navari said.
“We saw evidence of mild sedation in 20 percent, but there really
weren't any side effects. Those patients continued on the drug and
the sedation resolved by day 3 and 4."
But "the fatigue issue can be a problem," Erban told Reuters Health.
"A lot of patients are trying to balance their work and their home
life so they will want to find a formula where they get their
treatment and be as functional as possible," he said.
No patients discontinued treatment because of fatigue.
"The principal concern with olanzapine treatment is weight gain and
other metabolic consequences. However these usually occur with more
extended exposure, which is not applicable to this situation," said
Dr. David Greenblatt, a pharmacology researcher at Tufts.
"Since there was no other antipsychotic agent comparatively
evaluated in the study, it can't be concluded that olanzapine is
unique," he said by email. "Another antipsychotic might well have
similar properties."
SOURCE: http://bit.ly/1rzGOHe New England Journal of Medicine,
online July 13, 2016.
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